Organization Active NPI

Your Doctors Urgent Care & Pain Relief Center,LLC

  • Health Service Clinic/Center
  • Waldorf, MD
National Provider Identifier
1871035527
Registry record updated Nov 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
D0040209 Issued in MD
Legal business name
YOUR DOCTORS URGENT CARE & PAIN RELIEF CENTER,LLC
Practice address
177 Saint Patricks Dr
Waldorf, MD 20603-5532
Phone
(301) 396-4444
Fax
(301) 396-4449
NPI assigned
Nov 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Olayinka Olasimbo, PA-C
Title
Provider
Phone
(301) 396-4444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X D0040209 MD Primary

Addresses

Primary practice location

177 Saint Patricks Dr
Waldorf, MD 20603-5532

Mailing address

177 Saint Patricks Dr
Waldorf, MD 20603-5532
Phone (301) 396-4444

National Provider Directory

National Provider Directory

Locations

177 Saint Patricks Dr
Waldorf, MD 20603
Phone (301) 396-4444

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478908800000",
    "number": "1871035527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 SAINT PATRICKS DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035532",
            "telephone_number": "301-396-4444",
            "fax_number": "301-396-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 SAINT PATRICKS DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035532",
            "telephone_number": "301-396-4444",
            "fax_number": "301-396-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR DOCTORS URGENT CARE & PAIN RELIEF CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-12",
        "last_updated": "2016-11-12",
        "status": "A",
        "authorized_official_last_name": "OLASIMBO",
        "authorized_official_first_name": "OLAYINKA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "301-396-4444",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MD",
            "license": "D0040209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.